Understanding iron depletion and overload in blood donors
Normal iron stores in healthy men are about 1000 mg, whereas in healthy females only about 300 mg. A whole‐blood donation depletes the donor of approximately 225–250 mg of iron. For females, this means that often her iron stores are completely depleted after only one donation. Dietary absorption of iron can be up to 3·5–4 mg/day when iron stores are low, less when iron stores are higher. It can take 5 months or more for haemoglobin (Hb) to return to 80% of the drop in Hb following a whole‐blood donation, and longer to recoup iron stores; hence, to donate frequently, many donors may require iron supplements. Low ir...
Source: ISBT Science Series - November 20, 2016 Category: Hematology Authors: S. F. O'Brien, M. Goldman Tags: Invited Review Source Type: research
Managing the patient with haemoglobinopathy and multiple red cell antibodies
The main supportive treatment for haemoglobinopathies is repetitive red blood cell (RBC) transfusions, but this may lead to development of RBC alloimmunization which represents a critical and clinically relevant barrier. One of the greatest risk factors for alloimmunization is the antigen disparity between donor and recipient. This is prevalent with European donors and African recipients because of different blood group phenotypes. Various authors have reported that from 5·2 to 30% of thalassaemia patients and from 18% to as much as 47% of sickle cell anaemia (SCA) patients are affected. The presence of single or multiple...
Source: ISBT Science Series - November 20, 2016 Category: Hematology Authors: A. Matteocci Tags: Invited Review Source Type: research
Effectiveness of a red cell antigen ‐matching transfusion protocol in sickle cell disease patients
ConclusionsProspective antigen matching is an unattractive alloimmunization prophylaxis for SCPs if not associated with strategies to minimize the hazards related to transfusions at non‐index hospitals. Even in a highly mixed donor population, antigenic discrepancies in SCPs are high, increasing the risk of antibody development. (Source: ISBT Science Series)
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: M. R. Dezan, V. B. Oliveira, J. V. S. Bianchi, V. Rodrigues, J. H. Solano, F. C. Gomes, S. L. Bonif ácio, J. E. Levi, S. F. M. Guallandro, J. E. Krieger, A. C. Pereira, E. C. Sabino, A. Mendrone‐Júnior, C. L. Dinardo Tags: Original Paper Source Type: research
Blood donation and iron deficiency
Iron deficiency is prevalent in blood donor populations where up to 39%, 22% and 9% of frequently donating premenopausal women, postmenopausal women and men may be iron‐deficient, respectively. Moreover, iron deficiency is a global health issue estimated to concern as many as 2·7 billion people and explain half of the cases of anaemia worldwide. Iron deficiency manifesting as anaemia could affect the developing foetus and especially cognitive development. Furthermore, iron deficiency (anaemia) may impair scholastic achievements and work productivity and increase fatigue. Moreover, iron deficiency has been associated wit...
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: A. S. Rigas, O. B. Pedersen, C. Erikstrup, H. Hjalgrim, H. Ullum Tags: Congress Review Source Type: research
Immune regulation of sickle cell alloimmunization
Red blood cell (RBC) transfusion remains an important treatment for patients with sickle cell disease (SCD), and the majority of patients receive transfusions by adulthood. However, patients with SCD are at a high risk of alloimmunization, which can cause life‐threatening complications. The high rate of alloimmunization can in part be explained by chronic inflammatory condition in SCD characterized by significant immune and inflammatory activation. Heightened immune effector cell responses and/or impaired regulatory networks are likely to drive alloantibody production in alloimmunized SCD patients. In support of this, al...
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: K. Yazdanbakhsh, B. H. Shaz, C. D. Hillyer Tags: Congress Review Source Type: research
Current methods to manufacture human platelet lysates for cell therapy and tissue engineering: possible trends in product safety and standardization
Human platelet lysates (HPLs), obtained from therapeutic‐grade platelet concentrates (PC), are rich in growth factors and other bioactive molecules. HPL is increasingly evaluated as a substitute for foetal bovine serum (FBS), to likely become the next ‘gold standard’ supplement of growth media for clinical‐grade ex vivo propagation of human cells. HPL avoids the risks of immunological reactions against xenoproteins. HPL quality and safety benefit from the pathogen safety measures in place for producing PC for transfusion. Numerous studies support that HPL‐expanded mesenchymal stromal cells show improved prolifera...
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: M.L. Chou, T. Burnouf Tags: Congress Review Source Type: research
Dengue virus replication by platelets
Dengue virus (DENV) causes >100 million febrile infections annually. In ~2 million of these individuals, the disease may progress into life‐threatening haemorrhagic fever or shock syndrome. Approximately 200 million high‐titre infections remain asymptomatic and are a documented risk for transfusion transmission. Interestingly, both mild and severe DENV infections result in thrombocytopenia. Well‐established DENV receptors studies have suggested that similar receptors on platelets may facilitate comparable binding. To help explain DENV‐mediated platelet pathology, indirect evidence for a DENV‐platelet interacti...
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: E. L. G. Pryzdial, M. R. Sutherland, A. Y. Simon Tags: Congress Review Source Type: research
Red blood cell alloimmunization in Iranian beta ‐thalassemia patients: a systematic review and meta‐analysis
ConclusionThe prevalence of alloimmunization among Iranian thalassaemia has not been decreased from 1994 to 2013. In spite of detecting D antigen in pretransfusion test, the rate of anti‐D is high in our population. It shows the importance of more investigation on data on D variants. Although the rate of alloimmunization is low in Iran comparing to many other countries, there is a need to adopt some strategies to reduce alloimmunization. (Source: ISBT Science Series)
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: Parisa Darvishi, Milad Azami, Kourosh Sayehmiri, Fatemeh Sayehmiri, Alireza Goodarzi, Azita Azarkeivan, Ali Akbar Pourfathollah Tags: Invited Review Source Type: research
Education ‐based interventions to minimize sampling errors in transfusion
ConclusionsOur study highlights that simple, education‐based measures can be highly effective at reducing the incidence of sampling errors. The interventions we describe maybe easily implemented in resource‐limited settings. (Source: ISBT Science Series)
Source: ISBT Science Series - November 14, 2016 Category: Hematology Authors: S. Mel, S. Lim, C. Y. Soekojo, C. Thow, S. ‐P. Lang, S.‐Y. Lee, L.‐K. Tan Tags: Original Paper Source Type: research
A role for red cell clearance in antibody ‐mediated inhibition of erythrocyte alloimmunization?
Antibodies targeting erythrocytes can induce antibody‐mediated inhibition of erythrocyte alloimmunization, and anti‐D has been extremely successful in preventing haemolytic disease of the foetus and newborn (HDFN). It is desirable to replace the current donor‐derived anti‐D with a monoclonal antibody; however, the exact mechanism of IgG‐mediated suppression of red blood cell immune responses remains unclear. It has been proposed that the ability of anti‐D to prevent HDFN is due to IgG interactions with Fc receptors on phagocytic cells leading to rapid clearance of RhD+ red cells. Several monoclonal anti‐D alt...
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: D. Marjoram, Y. Cruz ‐Leal, L. Bernardo, A. H. Lazarus Tags: Congress Review Source Type: research
Global challenges of malaria risk – perspectives from transfusion‐transmitted malaria
Malaria is a protozoan disease that is transmitted by the Anopheles mosquito. It can however be transmitted by blood transfusion if the blood donor is parasitaemic. Of the five species of Plasmodium that causes malaria, P. falciparum causes the most severe form of malaria. Nearly half of the world's population is at risk of malaria. Mortality due to malaria has reduced by 48% from 839 000 deaths in 2000 to 438 000 deaths in 2015. This is largely due to a combination of two approaches, vector control and effective antimalarial drugs. There are challenges to be encountered in managing malaria risk. Some have evolved from the...
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: A. Owusu ‐Ofori, S. Owusu‐Ofori, I. Bates Tags: Congress Review Source Type: research
Geographic distribution of blood collections in Haiti before and after the 2010 earthquake
ConclusionHaiti's National Blood Safety Program managed a rapid expansion of collections outside of Port‐au‐Prince following the earthquake. Annual collections exceeded pre‐earthquake levels by 2012 and continued rising annually. Increased regional collections provided a greater share of the national blood supply, reducing dependence on Port‐au‐Prince for collections. (Source: ISBT Science Series)
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: A. Bjork, A. E. Jean Baptiste, E. Noel, N. P. D. Jean Charles, E. Polo, J. P. Pitman Tags: Congress Review Source Type: research
Interaction of leucocyte antibodies with endothelial cells in transfusion ‐related acute lung injury
Transfusion‐related acute lung injury (TRALI) is a severe pulmonary reaction characterized by pulmonary oedema, breathing distress and consequently hypoxia temporally associated with a blood transfusion event. In antibody‐mediated TRALI, alloantibodies reactive with recipient's neutrophils are mainly considered as responsible for lung injury. These antibodies target either human leucocyte antigens (HLAs) class I or II or human neutrophil antigens (HNAs). Antibody interaction with the cognate antigen is believed to induce neutrophil activation and sequestration, which consequently leads to endothelial damage and lung in...
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: B. Bayat Tags: Congress Review Source Type: research
Next ‐generation sequencing for blood group genotyping
In the field of immunohematology, blood group genotyping has become a very common approach for routine purpose to complement the gold standard serological studies, and to further guarantee the safety of patients. It has more recently explored the major advances in the available technologies for molecular analysis, including next‐generation sequencing (NGS). NGS, known as second‐generation technologies in its current format, has revolutionized the field of molecular genetics for the past decade. For the very recent years, a few pilot studies using various commercial platforms have paved the way towards blood group genot...
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: Y. Fichou, C. Le Mar échal, C. Férec Tags: Invited Review Source Type: research
Investigation and management of non ‐infectious transfusion reactions
Appropriate management of non‐infectious adverse transfusion reactions begins with recognition that a change in clinical status during or following a transfusion may represent an adverse event. Appropriate monitoring of patients during transfusion and explicit training of staff to recognize the signs and symptoms of adverse transfusion reactions is the key to diagnosis and to management. As some reactions may occur in the hours following transfusion, patient education and instruction on reporting relevant symptoms are also important. The typical symptoms that herald the onset of a transfusion‐related adverse event incl...
Source: ISBT Science Series - November 10, 2016 Category: Hematology Authors: Gwen Clarke Tags: Congress Review Source Type: research
